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Health-care reform results ‘disappointing’: report


September 19, 2013
By Mari-Len De

The independent agency tasked to monitor the progress of health-care reform in Canada for the past 10 years has reported "disappointing results."

In its Sept. 19 report, the Health Council of Canada found that, with some exceptions, changes to the country’s health-care system have not kept up with the evolving needs of Canadians.

“While the health accords set out to tackle some specific problems
in our health-care system, a lack of targets and measureable results
have not stimulated the improvements achieved by many other high income
countries,” said Dr. Jack Kitts, chair of the Health Council of Canada.

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Dr.
Kitts added despite Canada being one of the top spenders
internationally when it comes to health-care — spending more than $200
billion in 2012 — Canadians are in the middle of the pack when it comes
to the state of their health, and closer to the bottom when quality of
care is compared to other high-income countries.

The report said
progress on patient wait times for key procedures has stalled. Canada
now ranks among the worst in wait times — more than four months — for
elective surgeries.

Canada’s primary health-care services also
lag behind other countries, the report said. “While the number of
Canadians with access to a primary care provider has remained high,
close to half (47 per cent) of Canadians still cannot get a same-day or
next-day appointment, and their reliance on emergency rooms is among the
highest when compared to 10 other high-income countries.”

The
number of Canadians with two or more chronic conditions has continued to
increase as well, from 26 per cent in 2007 to 31 per cent in 2010.

“Seventy-six
percent of Canadians rate the quality of medical care received from
their primary care doctor as excellent or very good, but dig a little
deeper and you find that only 48 per cent of people with multiple
chronic diseases (typically, regular users of the health system)
describe the care they receive as excellent or very good,” said John
Abbott, CEO of the Health Council of Canada. “Mediocrity, when it comes
to our health care, is unacceptable, especially when we have the
resources and skills to do much better.”

The Health Council of
Canada urged provincial and territorial leaders to encourage and support
pan-Canadian collaboration that includes the federal government.

Commenting
on the report, the British Columbia Chiropractic Association (BCCA)
said providing Canadians increased access to neuromusculoskeletal care
will help alleviate the burden on the health-care system. Up to 80 per
cent of the population suffer from neuromusculoskeletal conditions
— such as muscle and joint problems — according to Dr. Jay Robinson,
president of the BCCA.

“Canada’s chiropractors are the only
doctor level primary care provider who can adequately diagnose and treat
these patients,” said Dr. Robinson. “Furthermore, the analysis shows
that when patients are seen by a chiropractor, the number of unnecessary
referrals to specialists is reduced dramatically.”

This saves the government health-care system a “great deal of time and money,” Dr. Robinson added.

Over
the past decade, however, equal access to neuromusculoskeletal service
at the primary care level “has gotten worse,” Dr. Robinson pointed out.

“As
more provinces have delisted chiropractic treatment from Canada’s
social health-care system, patients have been forced to find other ways
to pay for care,” Dr. Robinson said.

“Patients have been forced
to find other ways to pay for care. Third party insurance coverage,
generally available to those who are employees, is a poor replacement
for Canada's social medicine system. Self-employed persons, small 'Mom
and Pop' businesses – the backbone of our nation – and those living in
poverty typically have little to no access to coverage for appropriate
care for their problems.”

According to the Health Council of
Canada report, the country’s spending on physician salaries are
relatively high, compared to other high-income countries, and yet,
Canada has the lowest number of physicians per capita.

Dr.
Robinson said medical doctors are overwhelmed and are unable to meet the
demands of patients with common muscle and joint problems.

“Recent
documentation has shown that our GPs (general physicians) are sending
patients in record numbers to medical specialists for CT scans and MRIs
and other expensive tests. Reports from the specialists show that the
vast majority of these tests are not required. This has resulted in
excessive costs and increased wait lists throughout our nation,” the
BCCA president said.

He said Canada’s chiropractic industry is
constantly striving to improve patient experience and enhance the
“chiropractic and multidisciplinary health-care landscape” through
regular meetings and coordination among provincial and national
chiropractic colleges and associations.

“If all Canadians had
equal access to neuromusculoskeletal care, the burden on our system
would decrease even further,” Dr. Robinson said.

Meanwhile, the Canadian Chiropractic Association (CCA) wants the government to make wise use of health-care dollars.

"The Health Council of Canada report adds to the growing recognition that Canada is not being bold enough in pursuing the kinds of transformations that will truly achieve, 'better health, better care and better value,'" said Michael Heitshu, director of government affairs and policy at the CCA.

"At this point, with real spending having more than doubled since 1997, more money is not the answer. Instead, a fundamental rethink is needed of how care is delivered and by which providers. Health dollars must be focused on the most effective outcomes. That is why the Canadian Chiropractic Association is working to build awareness that Canadian chiropractors are already delivering better outcomes at a lower cost, and can do more as opportunities are created to increase the profession’s contributions to NMSK care."

The full report of the Health Council of Canada is available on the council’s website.


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